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Updated: Jan 29, 2026

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Outcomes of Children with Mild Obstructive Sleep Apnea Treated Nonsurgically: A Retrospective Review

Jocelyn L Kohn1, Michael B Cohen1,2, Prachi Patel3

  • 11 Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine, Boston, Massachusetts, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|February 13, 2019
PubMed

Insights

Mild obstructive sleep apnea (OSA) in children has an equal chance of improving or worsening without surgery. This finding aids parents in making informed decisions about treatment options for pediatric OSA.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Otolaryngology

Background:

  • Obstructive sleep apnea (OSA) in children is often caused by enlarged tonsils, with adenotonsillectomy as the primary treatment.
  • For mild pediatric OSA cases, non-surgical approaches are being explored as alternatives to surgery.

Purpose of the Study:

  • To evaluate the outcomes of children diagnosed with mild obstructive sleep apnea (OSA) who received non-surgical management.
  • To understand the natural progression of mild pediatric OSA without surgical intervention.

Main Methods:

  • A retrospective chart review of pediatric patients (ages 2-18) with mild OSA (apnea-hypopnea index [AHI] 1-5) treated non-surgically.
  • Comparison of serial polysomnograms to assess changes in AHI over time in patients managed without surgery.

Main Results:

  • Out of 104 children initially managed non-surgically, 91 underwent follow-up sleep studies.
  • Nearly equal proportions experienced a significant decrease (46%) or increase (41%) in their AHI.
  • No statistically significant difference was observed between the likelihood of improvement versus worsening of OSA.

Conclusions:

  • Mild pediatric obstructive sleep apnea demonstrates roughly equal probabilities of spontaneous improvement or deterioration over time.
  • These findings are crucial for counseling parents regarding the potential natural course of mild OSA and treatment choices.
Abstract

Keywords:
nonsurgical managementobstructive sleep apneapediatricpediatric OSApolysomnogramsleep study

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